کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2764667 1150934 2014 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Are written advance directives helpful to guide end-of-life therapy in the intensive care unit? A retrospective matched-cohort study
ترجمه فارسی عنوان
دستورالعمل های پیشنهادی برای هدایت درمان انتهای عمر در بخش مراقبت های ویژه مفید است؟ یک مطالعه گذشته نگر همجوشی کوهورت
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

PurposeThe purpose of the study was to determine whether treatment preferences in patients' advance directives (ADs) are associated with life-supporting treatments received during end-of-life care in the intensive care unit (ICU).Material and methodsThis is a retrospective cohort study, including patients who died in 4 ICUs of a university hospital in Germany. Patients with ADs were matched with 2 patients each without ADs using propensity scores.ResultsSixty-four (13%) of 477 patients had ADs, written a median of 109 weeks before admission. Five categories of applicability conditions were identified, most of them difficult to interpret in the ICU (eg, “advanced brain impairment” or “imminent death”). Advance directives contained a number of treatment refusals. Specifically, 63 of 64 refused “life-sustaining measures.” Compared to patients without ADs, patients with ADs were less likely to receive cardiopulmonary resuscitation (9% vs 23%, P = .029) and more likely to have do-not-resuscitate orders (77% vs 56%, P = .007). Therapy-limiting decisions and ICU length of stay did not differ between those with or without ADs.ConclusionsPatients with ADs are less likely to receive cardiopulmonary resuscitation but otherwise receive similar life-sustaining treatments compared to matched patients without ADs. More research is needed to explore reasons for potential noncompliance with patient preferences.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Critical Care - Volume 29, Issue 1, February 2014, Pages 128–133
نویسندگان
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